Page 222 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

220 Summary
Timely infectious disease notification and response is necessary to achieve ef- fective disease control.
Capacities for surveillance and response systems have been defined inter- nationally, among others by WHO, for infectious disease preparedness. Time- frames for notification and response systems, as well as quantitative perfor- mance indicators to measure timeliness are scarce however. Also standardized thresholds are lacking to determine whether these systems perform sufficiently timely.
This thesis aims to develop a timeframe for evaluation of timeliness in notifi- cation and response systems for infectious disease control, and to investigate which elements facilitate effective preparedness in terms of notification sys- tems, legal aspects, cooperation between stakeholders and costs involved.
The following research questions are addressed:
1. What is the delay of infectious disease notification to the MHS and report-
ing to the RIVM in the Netherlands?
2. What is the most appropriate timeframe for timeliness of infectious disease
notification for outbreak control? Are infectious diseases notified within
this timeframe in the Netherlands?
3. Which elements of notification systems facilitate timely notification?
4. What defines timely response and which elements in emergency prepared-
ness facilitate timeliness of response?
The introduction, Chapter 1, provides an outline of indicator based surveillance and response systems, being capacities for emergency preparedness. We de- veloped a ‘notification and response chain’ framework (figure 1, this thesis), in order to define successive steps for an infectious disease to be notified at local level, reported at national level, and for response measures implemented either at local or national level. We defined ‘notification delay’ (D3) as the time between laboratory test confirmation and notification to MHS, and ‘reporting delay’ (D6) as the time between notification at MHS and report received at RIVM. Legal and operational aspects of timely notification and response in the Netherlands are described as well as international defined preparedness frame- works by, among others, WHO and ECDC.
Section 1 studies timeliness of surveillance, focusing on notification systems for indicator based surveillance.
In Chapter 2 we analyze timeliness of notifications in the Netherlands under